title: Abnormal mammography and sonography associated with foreign-body giant-cell reaction after stereotactic vacuum-assisted breast biopsy with carbon marking.
abstract: BACKGROUND
  Carbon marking of the biopsy site and needle track following stereotactic breast biopsy in nonpalpable mammography-detected lesions provides for safe and accurate localization for subsequent surgical excision. No significant complications of carbon marking have been reported to date.
  
  
  OBJECTIVE
  To report follow-up imaging findings and histological changes (foreign-body giant-cell reaction) attributable to the use of carbon marking after vacuum breast biopsies.
  
  
  METHODS
  This was a retrospective study of 130 patients in a mammographic screening program with nonpalpable suspicious breast lesions that were referred for stereotactic directional vacuum-assisted breast biopsy with carbon marking. Histological diagnosis was benign in all cases, but 1-year follow-up mammograms demonstrated suspect findings in four of them.
  
  
  RESULTS
  For all four patients, the results of the initial stereotactic vacuum-assisted biopsy were benign, but mammographic follow-up and ultrasound findings revealed suspicious changes that, in all cases, were histologically shown to be foreign-body giant-cell reactions attributable to the use of carbon.
  
  
  CONCLUSIONS
  In four of 130 lesions (3%) that were carbon marked following stereotactic vacuum-assisted breast biopsy, and in which surgical excision was not required, the mammographic and ultrasound follow-up appearance of the breast simulated malignancy. The abnormality was attributable to the use of carbon, which represents a potential source of misdiagnosis.
authors.affiliation: Department of Radiology, Hospital Galdakao-Usansolo, Galdakao, Spain. marialuisa.ruizdelgado@osakidetza.net
authors.forename: M L
authors.initials: ML
authors.lastname: Ruiz-Delgado
authors.forename: J A
authors.initials: JA
authors.lastname: López-Ruiz
authors.forename: A
authors.initials: A
authors.lastname: Sáiz-López
mesh_terms: D001706:Biopsy; D001707:Biopsy, Needle; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D002606:Charcoal / Q000009:adverse effects*; D003937:Diagnosis, Differential; D005260:Female; D018226:Fibroadenoma / Q000175:diagnosis; D005348:Fibrocystic Breast Disease / Q000175:diagnosis; D005500:Follow-Up Studies; D005549:Foreign-Body Reaction / Q000175:diagnosis / Q000209:etiology*; D015743:Giant Cells, Foreign-Body / Q000000981:diagnostic imaging*; D006801:Humans; D008327:Mammography / Q000379:methods*; D012189:Retrospective Studies; D013238:Stereotaxic Techniques / Q000009:adverse effects*; D016217:Ultrasonography, Mammary / Q000379:methods*; D014618:Vacuum
chemical_list: D002606:Charcoal